Meningioangiomatosis: Multimodal Analysis and Insights From a Systematic Review

Neurology ◽  
2020 ◽  
pp. 10.1212/WNL.0000000000011372
Author(s):  
Alexandre Roux ◽  
Marc Zanello ◽  
Rossella Letizia Mancusi ◽  
Megan EH Still ◽  
Fábio A. Nascimento ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Resection ◽  
Epileptic Seizure ◽  
Seizure Control ◽  
Meta Analysis ◽  
Brain Lesion ◽  
Cochrane Library ◽  
Allelic Loss ◽  
Time Interval ◽  
Short Time Interval

Background:Meningioangiomatosis is a poorly studied, rare, benign, and epileptogenic brain lesion.Objective:To demonstrate that surgical resection and a short time interval to surgery improves epileptic seizure control, we performed a systematic review and meta-analysis of meningioangiomatosis cases.Methods:Using PRISMA-IPD guidelines, the authors performed a systematic review and meta-analysis of histopathologically proven meningioangiomatosis cases. Literature search in the French and English languages (PubMed, Embase, the Cochrane Library and the Science Citation Index) including all studies (January 1981 to June 2020) dealing with histopathologically proven meningioangiomatosis, without age restriction. We assessed clinical, imaging, histomolecular, management, and outcome findings of meningioangiomatosis patients.Results:Two-hundred and seven cases of meningioangiomatosis from 78 studies were included. The majority of meningioangiomatosis was sporadic, preferentially concerned male patients, younger than 20-year-old, and allowed a functionally independent status. Epileptic seizure was the main symptom, with 81.4% of patients having uncontrolled seizures at the time of surgery. Meningioangiomatosis mainly had frontal (32.3%) or temporal (30.7%) locations. Imaging presentation was heterogeneous, and the diagnosis was often missed pre-operatively. The histopathologic pattern was similar whatever the clinical presentation, and immunohistochemistry had limited diagnostic value. On molecular analysis, allelic loss at 22q12 was more frequent in samples of meningioangiomatosis-associated meningioma (37.5%) than in isolated meningioangiomatosis (23.1%). Time interval from diagnosis to surgery (p=0.011) and lack of surgical resection of the meningioangiomatosis (p=0.009) were independent predictors of post-operative seizure control.Conclusions:Due to low scientific evidence, a multicentric prospective study should help refining the management of meningioangiomatosis.

scholarly journals Diagnostic accuracy of transthoracic echocardiography for pulmonary hypertension: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033084 ◽  
Author(s):  
Jin-Rong Ni ◽  
Pei-Jing Yan ◽  
Shi-Dong Liu ◽  
Yuan Hu ◽  
Ke-Hu Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Hypertension ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Transthoracic Echocardiography ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Cochrane Library ◽  
Lower Sensitivity ◽  
Time Interval

ObjectiveTo evaluate the diagnostic accuracy of transthoracic echocardiography (TTE) in patients with pulmonary hypertension (PH).DesignSystematic review and meta-analysis.Data sources and eligibility criteriaEmbase, Cochrane Library for clinical trials, PubMed and Web of Science were used to search studies from inception to 19 June, 2019. Studies using both TTE and right heart catheterisation (RHC) to diagnose PH were included.Main resultsA total of 27 studies involving 4386 subjects were considered as eligible for analysis. TTE had a pooled sensitivity of 85%, a pooled specificity of 74%, a pooled positive likelihood ratio of 3.2, a pooled negative likelihood ratio of 0.20, a pooled diagnostic OR of 16 and finally an area under the summary receiver operating characteristic curve of 0.88. The subgroup with the shortest time interval between TTE and RHC had the best diagnostic effect, with sensitivity, specificity and area under the curve (AUC) of 88%, 90% and 0.94, respectively. TTE had lower sensitivity (81%), specificity (61%) and AUC (0.73) in the subgroup of patients with definite lung diseases. Subgroup analysis also showed that different thresholds of TTE resulted in a different diagnostic performance in the diagnosis of PH.ConclusionTTE has a clinical value in diagnosing PH, although it cannot yet replace RHC considered as the gold standard. The accuracy of TTE may be improved by shortening the time interval between TTE and RHC and by developing an appropriate threshold. TTE may not be suitable to assess pulmonary arterial pressure in patients with pulmonary diseases.PROSPERO registration numberPROSPERO CRD42019123289.

Surgical Treatment for Olfactory Groove Meningiomas: A Meta-Analysis of the Literature

2021 ◽  
Author(s):  
Wei Wang ◽  
Cong Chen ◽  
Siqi Chen
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Surgical Resection ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Csf Leak ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Olfactory Groove ◽  
Csf Leakage

Abstract Background Surgical resection of olfactory groove meningiomas (OGMs) is challenging and lots of surgical approaches can be chosen. We conducted a systematic review and meta-analysis of the studies investigating surgical resection of OGMs to better understand the surgical treatment of OGMs.Methods PubMed, Embase and Cochrane Library were used to search the studies reporting treatment outcomes of surgery for patients with OGMs. The final eligible studies were assessed using the Oxford Center for Evidence Based Medicine for level of evidence. Relevant parameters were extracted to perform descriptive and/or quantitative analyses.Results A total of 42 studies including 1673 patients were included in this systematic review (8 level 3 studies and 34 level 4 studies). Surgeries through transcranial approaches (TCAs) and endoscopic endonasal approach (EEA) were done on 1596 and 77 patients, respectively. Based on a random effects model, rates of gross total resection (GTR) and cerebrospinal fluid (CSF) leak were determined to be 92.4% (CI: 88.6-95.5%) and 5.9% (95% CI: 3.4-9%), respectively. The mortality following surgery was 1.6% (95% CI: 0.9-2.5%) under a fixed effects model. Through subgroup analyses, TCAs were found to be more favorable in GTR and CSF leakage compared to EEA. Besides, anterolateral TCA was associated with better control of CSF leakage than anterior TCA. Conclusion Surgical treatment is capable of achieving GTR in the vast majority of patients with OGMs and postoperative mortality is under well control. Transcranial approach allows a better chance of GTR and better control of CSF leak in comparison to EEA. In comparison to anterior TCA, anterolateral TCA is associated less mortality. However, low evidence level and significant heterogeneity of the included studies prevent the formation of more solid conclusions.

scholarly journals Response rate and diagnostic accuracy of PET/CT during and after neo-adjuvant therapies in oesophageal adenocarcinoma: protocol for a systematic review

2020 ◽  
Author(s):  
Jacqueline Jeffries ◽  
Bernadette Coles ◽  
Kevin Bradley ◽  
Alex Holborow ◽  
Elizabeth Smyth ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Surgical Resection ◽  
Adjuvant Treatment ◽  
Response Rate ◽  
Meta Analysis ◽  
Response Rates ◽  
Oesophageal Adenocarcinoma ◽  
Cochrane Library ◽  
Pet Ct

Abstract Background Oesophageal cancer is increasing in incidence and has a poor prognosis. Patients with potentially curable disease have a staging positron emission tomography (PET) examination combined with a computed tomography (CT) to assess loco-regional and distant disease. Although a small proportion of patients are suitable for attempted surgical resection, the majority will receive neo-adjuvant therapy (chemotherapy with or without radiotherapy) before their operation. The current regimen prescribes all patients to complete the neo-adjuvant treatment prior to surgery, but some patients will not experience a beneficial response. A repeat PET/CT after one cycle of neo-adjuvant treatment may identify early response or non-response and could alter subsequent management. The purpose of this systematic review and meta-analysis is to estimate the early and completion response rate defined by fluorodeoxyglucose (FDG)-PET, its diagnostic accuracy and explore associated factors. Methods Primary studies reporting response rates and diagnostic accuracy of PET/CT will be identified from MEDLINE, Embase, Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science, International Clinical Trials Registry Platform (ICTRP) Search Portal and ClinicalTrials.gov databases. Peer-reviewed studies published from 2005 onwards will be included. Data will be extracted from selected studies and a meta-analysis using a random effects model will be attempted. Pooled early and completion response rates, and diagnostic accuracy (sensitivity and specificity), will be calculated from available data. Heterogeneity between studies, risk of bias and methodological quality will be assessed. Discussion This systematic review and meta-analysis will identify and synthesise evidence to determine early and completion response rates to neo-adjuvant treatment and the corresponding diagnostic accuracy of PET/CT. This strategy has the potential to identify patients that will not respond to the treatment and to offer this group an alternative pre-operative treatment or proceed directly to operation, thereby avoiding a delay in surgical resection and optimising patient outcomes.

Does non-institutionalized elders have a better oral health status compared to institutionalized ones? A systematic review and meta-analysis

2020 ◽  
Vol 25 (6) ◽  
pp. 2177-2192 ◽  
Author(s):  
Ilky Pollansky Silva e Farias ◽  
Simone Alves de Sousa ◽  
Leopoldina de Fátima Dantas de Almeida ◽  
Bianca Marques Santiago ◽  
Antonio Carlos Pereira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Status ◽  
Oral Health ◽  
Dental Caries ◽  
Meta Analysis ◽  
Oral Health Status ◽  
Cochrane Library ◽  
Caries Experience ◽  
Institutionalized Elderly ◽  
Periodontal Status

Abstract This systematic review compared the oral health status between institutionalized and non-institutionalized elders. The following electronic databases were searched: PubMed (Medline), Scopus, Web of Science, Lilacs and Cochrane Library, in a comprehensive and unrestricted manner. Electronic searches retrieved 1687 articles, which were analyzed with regards to respective eligibility criteria. After reading titles and abstracts, five studies were included and analyzed with respect their methodological quality. Oral status of institutionalized and non-institutionalized elderly was compared through meta-analysis. Included articles involved a cross-sectional design, which investigated 1936 individuals aged 60 years and over, being 999 Institutionalized and 937 non-institutionalized elders. Studies have investigated the prevalence of edentulous individuals, the dental caries experience and the periodontal status. Meta-analysis revealed that institutionalized elderly have greater prevalence of edentulous (OR = 2.28, 95%CI = 1.68-3.07) and higher number of decayed teeth (MD = 0.88, 95%CI = 0.71-1.05) and missed teeth (MD = 4.58, 95%CI = 1.89-7.27). Poor periodontal status did not differ significantly between groups. Compared to non-institutionalized, institutionalized elders have worse dental caries experience.

scholarly journals Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyune June Lee ◽  
Sung Min Kim ◽  
Ji Yean Kwon
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Effect Size ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Peripartum Depression

Abstract Background Peripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. Methods We performed a systematic review that followed the PRISMA guidelines. We searched for studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference, and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method. Results The therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.944–1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.689–1.459), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346 (95% CI: 0.214–0.506), a meaningful result. There were no severe side effects to the mothers or fetuses. Conclusions From various perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.

scholarly journals Effectiveness of Nutritional Education for Obese Older Adults With Frailty: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 401-401
Author(s):  
Yue-Heng Yin ◽  
Liu Yat Justina
Keyword(s):  
Systematic Review ◽  
Physical Function ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Well Being ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Nutritional Education ◽  
Hand Search ◽  
Education Interventions

Abstract Obesity has been shown to intensify the decline of physical function and lead to frailty. Nutrition is an important method in managing obesity and frailty, while seldom reviews have ever explored the effects of nutritional education interventions. We conducted a systematic review (PROSPERO: CRD42019142403) to explore the effectiveness of nutritional education interventions in managing body composition and physio-psychosocial parameters related to frailty. Randomized controlled trials and quasi-experimental studies were searched in CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, PubMed and Scopus from 2001 to 2019. Hand search for the reference lists of included papers was conducted as well. We assessed the quality of included studies by Cochrane risk of bias tool. Meta-analyses and narrative synthesis were used to analyse the data. Two studies with low risk of bias were screened from 180 articles, which involved 177 older people with an average age of 69.69±4.08 years old. The results showed that nutritional education was significantly effective in reducing body weight and fat mass than exercises, and it was beneficial to enhancing physical function and psychosocial well-being. But the effects of nutritional education in increasing muscle strength were not better than exercises. The combined effects of nutritional education and exercises were superior than either exercises or nutritional education interventions solely in preventing the loss of lean mass and bone marrow density, and in improving physical function. Due to limited numbers of relevant studies, the strong evidence of effectiveness of nutritional education interventions on reversing frailty is still lacking.

scholarly journals Mitochondrial transplantation therapy for ischemia reperfusion injury: a systematic review of animal and human studies

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kei Hayashida ◽  
Ryosuke Takegawa ◽  
Muhammad Shoaib ◽  
Tomoaki Aoki ◽  
Rishabh C. Choudhary ◽  
...  
Keyword(s):  
Systematic Review ◽  
Reperfusion Injury ◽  
Animal Studies ◽  
Ischemia Reperfusion Injury ◽  
Myocardial Dysfunction ◽  
Ischemia Reperfusion ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Human Studies ◽  
Cochrane Library

Abstract Background Mitochondria are essential organelles that provide energy for cellular functions, participate in cellular signaling and growth, and facilitate cell death. Based on their multifactorial roles, mitochondria are also critical in the progression of critical illnesses. Transplantation of mitochondria has been reported as a potential promising approach to treat critical illnesses, particularly ischemia reperfusion injury (IRI). However, a systematic review of the relevant literature has not been conducted to date. Here, we systematically reviewed the animal and human studies relevant to IRI to summarize the evidence for mitochondrial transplantation. Methods We searched MEDLINE, the Cochrane library, and Embase and performed a systematic review of mitochondrial transplantation for IRI in both preclinical and clinical studies. We developed a search strategy using a combination of keywords and Medical Subject Heading/Emtree terms. Studies including cell-mediated transfer of mitochondria as a transfer method were excluded. Data were extracted to a tailored template, and data synthesis was descriptive because the data were not suitable for meta-analysis. Results Overall, we identified 20 animal studies and two human studies. Among animal studies, 14 (70%) studies focused on either brain or heart IRI. Both autograft and allograft mitochondrial transplantation were used in 17 (85%) animal studies. The designs of the animal studies were heterogeneous in terms of the route of administration, timing of transplantation, and dosage used. Twelve (60%) studies were performed in a blinded manner. All animal studies reported that mitochondrial transplantation markedly mitigated IRI in the target tissues, but there was variation in biological biomarkers and pathological changes. The human studies were conducted with a single-arm, unblinded design, in which autologous mitochondrial transplantation was applied to pediatric patients who required extracorporeal membrane oxygenation (ECMO) for IRI–associated myocardial dysfunction after cardiac surgery. Conclusion The evidence gathered from our systematic review supports the potential beneficial effects of mitochondrial transplantation after IRI, but its clinical translation remains limited. Further investigations are thus required to explore the mechanisms of action and patient outcomes in critical settings after mitochondrial transplantation. Systematic review registration The study was registered at UMIN under the registration number UMIN000043347.

scholarly journals EXPRESS: Stroke risk following traumatic brain injury: systematic review and meta-analysis

2021 ◽  
pp. 174749302110042
Author(s):  
Grace Mary Turner ◽  
Christel McMullan ◽  
Olalekan Lee Aiyegbusi ◽  
Danai Bem ◽  
Tom Marshall ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Vitamin K Antagonists ◽  
Cochrane Library ◽  
Control Group ◽  
Large Sample Size ◽  
Hazard Ratios ◽  
Increased Risk ◽  
The Cochrane Library

Aims To investigate the association between TBI and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4th December 2020. We used random-effects meta-analysis to pool hazard ratios (HR) for studies which reported stroke risk post-TBI compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-TBI control group, all found TBI patients had significantly increased risk of stroke compared to controls (pooled HR 1.86; 95% CI 1.46-2.37). Findings suggest stroke risk may be highest in the first four months post-TBI, but remains significant up to five years post-TBI. TBI appears to be associated with increased stroke risk regardless of severity or subtype of TBI. There was some evidence to suggest an association between reduced stroke risk post-TBI and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion TBI is an independent risk factor for stroke, regardless of TBI severity or type. Post-TBI review and management of risk factors for stroke may be warranted.

scholarly journals Optimal Application of Forced Air Warming to Prevent Peri-Operative Hypothermia during Abdominal Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (5) ◽  
pp. 2517
Author(s):  
Yoonyoung Lee ◽  
Kisook Kim
Keyword(s):  
Systematic Review ◽  
Abdominal Surgery ◽  
Critical Appraisal ◽  
Meta Analysis ◽  
Upper Body ◽  
Cochrane Library ◽  
Randomized Controlled ◽  
Forced Air Warming ◽  
Forced Air ◽  
Full Body

Patients who undergo abdominal surgery under general anesthesia develop hypothermia in 80–90% of the cases within an hour after induction of anesthesia. Side effects include shivering, bleeding, and infection at the surgical site. However, the surgical team applies forced air warming to prevent peri-operative hypothermia, but these methods are insufficient. This study aimed to confirm the optimal application method of forced air warming (FAW) intervention for the prevention of peri-operative hypothermia during abdominal surgery. A systematic review and meta-analysis were conducted to provide a synthesized and critical appraisal of the studies included. We used PubMed, EMBASE, CINAHL, and Cochrane Library CENTRAL to systematically search for randomized controlled trials published through March 2020. Twelve studies were systematically reviewed for FAW intervention. FAW intervention effectively prevented peri-operative hypothermia among patients undergoing both open abdominal and laparoscopic surgery. Statistically significant effect size could not be confirmed in cases of only pre- or peri-operative application. The upper body was the primary application area, rather than the lower or full body. These findings could contribute detailed standards and criteria that can be effectively applied in the clinical field performing abdominal surgery.

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